Fillable RAFFLE LICENSE REPORTING FORM CITY OF DECATUR FINANCE (City of Decatur Illinois)

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RAFFLE LICENSE REPORTING FORM CITY OF DECATUR FINANCE (City of Decatur Illinois)

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RAFFLE LICENSE REPORTING FORM
According to City Code Chapter 62 Section 8c
Organization Name____________________________________________________________
Address
____________________________________________________________________________________
Street City State Zip Code
Date of Raffle _______________________ Total value of all prizes awarded $______________
Gross Receipts $_______________________
Expenses $_______________________
Net Proceeds $_______________________
Distribution of Net Proceeds:
Date Payee Purpose Amount
_______ ____________________ __________________ ____________
_______ ____________________ __________________ ____________
_______ ____________________ __________________ ____________
_______ ____________________ __________________ ____________
_______ ____________________ __________________ ____________
_______ ____________________ __________________ ____________
_______ ____________________ __________________ ____________
CITY OF DECATUR
FINANCE DEPARTMENT
#1 GARY K ANDERSON PLAZA
DECATUR IL 62523
LICENSING – (217) 424-2709
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RAFFLE LICENSE REPORTING FORM CITY OF DECATUR FINANCE (City of Decatur Illinois)

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Completed 15 February 2021

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